Myocardial extracellular volume fraction to differentiate healthy from cardiomyopathic myocardium using dual-source dual-energy CT

ObjectiveTo evaluate the feasibility of dual-energy CT (DECT)-based iodine quantification to estimate myocardial extracellular volume (ECV) fraction in patients with and without cardiomyopathy (CM), as well as to assess its ability to distinguish healthy myocardial tissue from cardiomyopathic, with the goal of defining a threshold ECV value for disease detection.MethodsTen subjects free of heart disease and 60 patients with CM (mean age 66.4 ± 9.4; 59 males and 11 females; 40 ischemic and 20 non-ischemic CM) underwent late iodine enhanced DECT imaging. Myocardial iodine maps were obtained using 3-material decomposition. ECV of the left ventricle was estimated from hematocrit levels and the iodine maps using the AHA 16-segment model. Receiver operating characteristic curve analysis was performed, with corresponding area under the curve, along with Youden's index assessment, to establish a threshold for CM detection.ResultsThe median ECV for healthy myocardium, non-ischemic CM, and ischemic CM were 25.4% (22.9–27.3), 38.3% (33.7–43.0), and 36.9% (32.4–41.1), respectively. Healthy myocardium showed significantly lower ECV values compared to ischemic and non-ischemic CM (p < 0.001). From Youden's index analysis, an ECV>29.5% would indicate the presence of CM in the myocardium (sensitivity = 90.3; specificity = 90.3); the AUC for this criterion was 0.950 (p < 0.001).ConclusionThe findings of this study resulted in a statistically significant distinction between healthy myocardium and CM ECVs. This led to the establishment of a promising threshold ECV value that could facilitate the differentiation between healthy and diseased myocardium, and highlights the potential of this DECT methodology to detect cardiomyopathic tissue.     

Changes in iodine status among US adults, 2001–2012

Urinary iodine concentrations (UICs) in the US have been reported to be stable since 1988–1994, although those in selected subgroups remained low. We aimed to investigate iodine status among adults (≥20 years) by two different criteria of assessing iodine deficiency in population. Utilizing National Health and Nutrition Examination Surveys 2001–2012, we conducted linear logistic regressions adjusting for covariates. The prevalence of <50?μg/L UIC was higher in women than in men; increased from 11.6% (2001–2004) to 13.2% (2009–2012) at the national level and in young adults, non-Hispanic blacks (NHBs) and non-users of iodine-containing supplements (all, p?<0.05); the adjusted odds ratios (95%CI) in young adults (1.54 [1.11–2.15], p =?0.0007) and NHBs (1.70 [1.15–2.52], p =?0.0078). Median UICs confirm women and NHBs being in borderline iodine status. Recognizing the critical consequence of iodine deficiency particularly in women and NHBs, regular monitoring of iodine status is important for public health in the US.     

碘131配合选择性颈淋巴结清除术对甲状腺癌的疗效及唾液腺功能的影响

目的:探讨I131配合选择性颈淋巴结清除术治疗甲状腺癌(TC)的疗效和对患者唾液腺功能的影响。方法:选取2009年1月—2013年9月期间确诊治疗的TC患者60例,随机分均分为对照与观察组,对照组患者给予常规甲状腺切除术,观察组患者在此基础上给予选择性颈淋巴结清除术与I131治疗,其中又根据I131摄入量均分为高剂量亚组(3 500 m Bq)和低剂量亚组(1 000 m Bq),分析患者疗效和唾液腺功能指标及术后生存情况。结果:观察组首次清甲成功率与治疗总有效率均明显高于对照组(均P0.05);唾液腺功能参数方面,手术组优于低剂量亚组,低剂量亚组优于高剂量亚组(均P0.05);观察组中高、低剂量亚组5年生存率无明显差异,但均高于对照组(均P0.05)。结论:I131配合选择性颈淋巴结清除术治疗可有效提高对TC手术患者的疗效并改善预后,虽有唾液腺功能方面不良反应,但低剂量治疗症状较轻,在患者接受范围内。     

Antibacterial treatment needed for severe early childhood caries

OBJECTIVES: To assess the effects of a single 10% povidone iodine application as an adjunct to extensive surgical procedures in the clinical treatment of children with early childhood caries. METHODS: Twenty-two children scheduled for dental treatment under general anesthesia were randomized into either an intervention group (10% povidone iodine), or a control group (phosphate buffered saline). Either povidone iodine or phosphate buffered saline was applied to teeth and soft tissues after prophylaxis and all operative dental procedures, followed by 1.23% acidulated phosphate fluoride gel. Saliva samples taken at baseline, and after 1 hour, 3 weeks and 3 months were assayed for mutans streptococci, lactobacilli and total viable bacteria. Caries lesions were recorded at baseline and at one year. RESULTS: Mutans streptococci and lactobacilli levels in the povidone iodine group were significantly reduced relative to baseline at 1 hour, 3 weeks and 3 months. At one year at least 60% of subjects had new caries lesions in each group, and there was no significant difference in caries increment between the two groups. CONCLUSIONS: Even prophylaxis, fluoride gel application and complete surgical treatment of caries at baseline were insufficient to prevent new caries in over 60% of the patients in these high caries risk infants. Although the one-time treatment with povidone iodine reduced mutans streptococci and lactobacilli levels for up to 3 months this therapy failed to additionally reduce future caries formation over one year, indicating that repeated antibacterial treatments will be needed to control high levels of cariogenic bacteria.     

碘化钾制备的碘涂层钛板的抗菌性能研究

目的探讨利用碘化钾制备碘涂层钛板的可行性,并验证其抗菌性能。方法以碘化钾作为电解液,使用电泳沉积法将碘负载到钛板表面,制备出碘涂层钛板。通过扫描电镜与能谱分析,观察碘涂层钛板的表面征象和成分结构。实验分组:对照组是经过预处理但未行载碘的钛板,共10块;实验组是经过预处理后再行载碘的碘涂层钛板,根据电解液浓度的不同分为3组:1000 mg/L、2000 mg/L、4000 mg/L组,每组各10块。使用1×106 CFU/mL的金黄色葡萄球菌(ATCC25923)进行体外抗菌实验,并对其抗菌性能进行研究。结果碘涂层钛板外观呈灰色,表面可均匀覆盖一层平整、无塌陷的涂层,电镜下见其表面可形成碘涂层,局部散在分布大小不等的不规则陷凹。对照组、1000 mg/L组、2000 mg/L组、4000 mg/L组的钛板碘含量分别为0、5.10、10.32、15.05 mass%;其体外抗菌菌落计数分别为56.00±5.09、21.40±2.76、9.10±2.51和2.00±1.88,4组之间菌落计数比较差异均有统计学意义(P<0.05)。结论碘化钾作为电解液,使用电泳沉积法可成功制备出碘含量稳定、涂层分布均匀的碘涂层钛板。体外抗菌实验证明碘涂层钛板的抗菌性能强于未载碘钛板。     

超声介导125I放射性粒子植入治疗晚期恶性肿瘤

目的探讨超声引导^125I放射性粒子植入治疗晚期恶性肿瘤的可行性和效果。 方法在超声引导下，经皮或经阴道穿刺晚期恶性肿瘤，并依据放射治疗计划植入适当数量的^125I放射性粒子。 结果28例患者均获成功。超声能清晰显示肿块，准确引导植入针的插入，成功监视粒子的植入。 结论超声引导^125I放射粒子植入治疗晚期恶性肿瘤安全、微创、并发症少，疗效肯定。     

125I粒子永久性组织间植入治疗浅表恶性转移肿瘤

目的 探讨125I粒子术中组织间植入治疗浅表恶性转移肿瘤的临床效果.方法 在B超引导下将125I粒子植入24例恶性肿瘤切除后28处浅表转移病灶肿瘤组织内,治疗1个月后观察疼痛缓解情况和瘤灶大小等变化,并定期随访.结果 24例患者术后均恢复良好,未因植入125I粒子而导致严重并发症,随访1～14个月,中位随访8个月,均无不良反应发生.125I粒子植入1个月后,肿瘤病灶疼痛症状完全缓解23处,部分缓解5处;肿瘤病灶体积部分缓解25处,3处无改变.结论 125I粒子组织间植入治疗浅表恶性转移肿瘤,方法简便,近期疗效确切,能缓解癌性疼痛及局部压迫等症状,提高患者的生存质量.